Name of the Procedure:

• Common Name: Custom Hand Orthosis
• Technical Term: Hand Orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment (L3919)

Summary

A custom hand orthosis is a medical device designed to support, protect, and immobilize the hand. It is made without joints and may include soft linings and adjustable straps for comfort. The orthosis is custom-fabricated to fit the patient's hand precisely and includes professional fitting and adjustments.

Purpose

A hand orthosis is used to:

• Immobilize the hand for healing or protection.
• Support weak or deformed structures of the hand.
• Improve hand function and alignment.
• Relieve pain. The expected outcome is enhanced hand stability, improved functionality, and reduced pain.

Indications

• Trauma or injury to the hand, such as fractures or sprains.
• Post-surgical immobilization.
• Chronic conditions like arthritis or carpal tunnel syndrome.
• Neurological conditions causing hand weakness or deformity.
• Patients requiring precise fit and support that off-the-shelf orthoses cannot provide.

Preparation

• No fasting or major medication adjustments are typically needed.
• Initial assessment by a healthcare professional to measure and evaluate hand function is required.
• Diagnostic tests like X-rays may be needed to assess bone and soft tissue conditions.

Procedure Description

1. Initial evaluation and measurements are taken by a qualified healthcare provider.
2. A custom mold of the hand may be made or digital scanning may be used.
3. The orthosis is fabricated based on the exact dimensions and needs of the patient.
4. During a fitting appointment, the orthosis is placed on the hand, and adjustments are made to ensure a proper fit.
5. The patient is instructed on how to put on, remove, and care for the orthosis.
   • No anesthesia or sedation is required for this procedure.

Duration

The fitting and adjustment session typically takes about 1-2 hours.

Setting

• Outpatient clinic.
• Orthotics and prosthetics workshop.

Personnel

• Orthotist or prosthetist.
• Occupational therapist or physical therapist.
• Physician may be involved in the initial assessment and ongoing care.

Risks and Complications

• Minor skin irritation or pressure sores.
• Incorrect fit leading to discomfort.
• Possible allergic reaction to materials used.
• In rare cases, delayed adjustment or breakage requiring re-fitting.

Benefits

• Immediate support and stabilization of the hand.
• Reduction in pain and discomfort.
• Improved hand function and alignment.
• Custom fit ensures better compliance and effectiveness.

Recovery

• Patients can typically resume daily activities immediately, with some restrictions.
• Regular follow-up appointments may be needed to adjust the orthosis.
• Compliance with wearing instructions is crucial for optimal outcomes.

Alternatives

• Off-the-shelf hand braces.
• Physical therapy or rehabilitation exercises.
• Medications for pain and inflammation.
• Surgery, in severe cases.
• Each alternative has its pros and cons, mainly revolving around cost, convenience, and effectiveness.

Patient Experience

• Minimal discomfort during measurement and fitting.
• Possible mild discomfort initially as the hand adjusts to the orthosis.
• Pain management is generally minimal since the procedure is non-invasive.
• Patients often report a significant improvement in comfort and hand function soon after using the orthosis.